A Systemic Inflammation Response Index Could be a Predictive Factor for mFOLFIRINOX in Metastatic Pancreatic Cancer

Low Systemic Inflammation Response Index Predicts Good Prognosis in Locally Advanced Pancreatic Carcinoma Patients Treated with Concurrent Chemoradiotherapy

“…It is quite difficult for us to comment conclusively on this finding in the lack of similarly designed comparative past LAPC studies. In any case, our display SIRI cutoff esteem at 1.6 and the independent link between the prevalent survival outcomes in patients with SIRI <1.6 appear to be in good accordance with the results of historic chemotherapy studies investigating the prognostic worth of SIRI in PC patients [ 16 , 17 ]. In the first of ever SIRI study, Qi et al [ 16 ] tested the SIRI in advanced PCs receiving palliative chemotherapy and showed that the SIRI <1.8 group had notably longer median TTP ( P = 0.003) and OS ( P < 0.001) durations than the SIRI ≥1.8 group.…”

“…In view of these results, the authors counseled the use of SIRI as a novel predictor of survival for advanced PC patients receiving chemotherapy and proposed its use for the identification of the appropriate candidates for aggressive therapy in the routine oncology practice. These findings were later asserted in a subsequent SIRI study in metastatic PC patients who received FOLFIRINOX chemotherapy with an ideal cutoff defined at 1.9 points [ 17 ]. Proposing an almost universal prognostic utility for SIRI in discrimination of patients groups with distinctive outcomes, further investigations verified these findings in the renal clear cell, hepatocellular, nasopharyngeal, and esophageal squamous cell carcinomas [ 18 – 21 ], as well.…”

“…Since the systemic inflammation has been shown to diminish the host immunity, facilitate escape from immune surveillance, inhibit apoptosis and promote neoangiogenesis, tumor aggressiveness, invasion capacity, and metastasis; various indexes of systemic inflammation response including the NLR, PLR, MLR, PNI, PI, Glasgow prognostic score (GPS), modified GPS, and ALI have been examined broadly in patients presenting with various cancers and demonstrated to reliably predict their prognosis [ 7 – 15 ]. The SIRI, another recently discovered indicator of systemic inflammation, has been shown to be a novel relevant index that can accurately predict the prognosis of patients with pancreatic [ 16 , 17 ], renal clear cell [ 18 ], hepatocellular [ 19 ], nasopharyngeal [ 20 ], and esophageal squamous cell carcinomas [ 21 ] who received various anticancer treatments. Nevertheless, despite its first discovery in advanced PC patients, it was surprising for us to notice that the SIRI was never examined before in LAPC patients who experienced radical CRT.…”

“…Recently, Qi et al [ 16 ] have shown that the systemic inflammation response index [SIRI = neutrophil (N) × monocyte (M)/lymphocyte (L)] was able to reliably laminate PC patients into two unique prognostic groups after chemotherapy with regards to the time to progression (TTP) and overall survival (OS). Likewise, in a succeeding study, SIRI was found to be also connected with clinical outcomes of metastatic PC patients who received FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) chemotherapy [ 17 ]. Further studies in renal clear cell [ 18 ], hepatocellular [ 19 ], nasopharyngeal [ 20 ], and esophageal squamous cell carcinomas [ 21 ] affirmed the prognostic worthiness of SIRI in these tumor types, as well.…”

Systemic Inflammation Response Index and weight loss as prognostic factors in metastatic pancreatic cancer: A concept study from the PANTHEIA-SEOM trial

“…This inflammatory milieu is further enriched by cytokines secreted within the tumor microenvironment, which not only directly affect tumor cells, but also accelerate tumor progression through their interaction with the surrounding chemokine system and by stimulating the epithelial to mesenchymal transition[ 19 ]. Against this inflammatory backdrop, the Systemic Inflammatory Response Index (SIRI) based on neutrophil, monocyte, and lymphocyte counts, has emerged as a prognostic factor in pancreatic cancer[ 14 , 15 , 17 , 20 - 22 ]. Its utility extends to predicting OS in those undergoing chemotherapy, reflecting the status of both the immune response and systemic inflammation.…”